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Silent Pericardial Effusion
OP Kapoor
 
 

It is very important to know that like pleural effusion, pericardial effusion will produce signs and symptoms depending on the amount of fluid present in the pericardium. A patient having a minimal pericardial effusion may never develop a large amount of fluid. But, when diagnosed, it is very helpful in confirming a diagnosis.

In the last few years, I have seen dozens of patients with mild pericardial effusion. A number of them were missed on X-ray chest because the size of the cardiac shadow was not big enough and the usual radiological signs of pericardial effusion were absent.

In fact many of these patients were picked up either on CT scan or 2D Echocardiography.

Although generalised anasarca is one of the common causes of a small pericardial effusion, somehow in the modern days with the latest diuretics available in the market, patients having pericardial fluid are rarely seen. The following are a few conditions, where I have often seen such pericardial effusion. These are :

  1. Patients having disseminated TB.
  2. Patients having SLE.
  3. Patients having AIDS are more susceptible to develop pericardial TB.
  4. Patients having rheumatic arthritis.
  5. Patients having AOSD (Adult Onset Still’s disease).
 
Ex. Hon. Physician, Jaslok Hospital and Bombay Hospital, Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.
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